出口产品责任险投保书.docx

出口产品责任险投保书EXPORTPRODUCTSLIABILITYINSURANCEAPPLICATION本公司对问卷各项填写内容除作为核保及其它保险程序上的参考外不另为其它用途并予以保密。Theinformationprovidedherewillbeusedforinsuranceunderwritingandrelatedprocessingonlyandwillbekeptconfidential.PartI–基本信息BasicInformation1.投保人/被保险人名称及注册地址Name&addressofapplicant/insured(includingallsubsidiaries):2.被保险人成立形式TheLegalFormoftheInsured□独资Individual_________□合伙Partnership_________□公司Corporation__________□合资Jointventure______3.请选出被保险人的经营性质PleasetickthebusinessnatureoftheInsured:□制造商Manufacturer__________□经销商Distributor_________□贸易公司TradingCompany_________□其它(请说明)other(pleasestate)_________________4.投保公司从事该行业几年？如果有的话请提供公司网址HowlonghastheInsuredbeeninthisbusiness?Pleaseprovidecompanywebaddressifthereisone.5.被保险人在美国或加拿大有分支机构或代表处？如有请提供以下资料DoestheInsuredhaveanysubsidiariesaffiliatesorrepresentativeofficeintheUSAand/orCanada?IfYESpleasegivethefollowingdetails:□Yes□No公司名称NameofCompany:_______________________________________________公司性质BusinessNature:____________________________________________地址Address:_______________________________________________________与被保险人关系RelationshipwiththeInsured:________________PARTII-产品信息PRODUCT(s)INFORMATION(请附产品说明书、产品目录、测试报告、用户使用手册。PleaseattachProductBrochuresCatalogueTestingReportsUserManuals)1.1）请简要说明贵公司目前所生产或销售的所有产品并说明所需承保的产品。Pleaselistallproductsproducedand/ordistributedbyyouandspecifytheproductstobeinsured.______________________________________________________________________________2）贵公司从事生产或销售这些产品多长时间?Howmanyyearshaveyoubeenmanufacturingordistributingtheseproducts?_______________________________________________________